| NPI | 1275943516 |
|---|---|
| Former Legal Business Name | SAMIR BALANEY DDS LLC |
| Entity Type | Organization |
| Authorized Contact | SAMIR BALANEY Owner/Dentist 708-383-2992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019028291) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2014-05-07 |